Prior studies suggest that exposure to the natural environment may be important for optimal mental health. The present study examines the association between block-level greenness (vegetative presence) and mental health outcomes, in a population-based sample of 249,405 U.S. Medicare beneficiaries aged ≥65 years living in Miami-Dade County, Florida, USA, whose location did not change from 2010 to 2011. Multilevel analyses examined relationships between greenness, as measured by mean Normalized Difference Vegetation Index from satellite imagery at the Census block level, and each of two mental health outcomes; Alzheimer’s disease and depression, respectively, after statistically adjusting for age, gender, race/ethnicity, and neighborhood income level of the individuals. Higher block-level greenness was linked to better mental health outcomes: There was a reduced risk of Alzheimer’s disease (by 18%) and depression (by 28%) for beneficiaries living in blocks that were 1 SD above the mean for greenness, as compared to blocks that were 1 SD below the mean. Planned post-hoc analyses revealed that higher levels of greenness were associated with even greater mental health benefits in low-income neighborhoods: An increase in greenness from 1 SD below to 1 SD above the mean was associated with 37% lower odds of depression in low-income neighborhoods, compared to 27% and 21% lower odds of depression in medium- and high-income neighborhoods, respectively. Greenness may be effective in promoting mental health in older adults, particularly in low-income neighborhoods, possibly as a result of the increased opportunities for physical activity, social interaction, or stress mitigation.

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Architectural features that facilitate direct, in-person interactions may be beneficial for Hispanic elders' mental health.

BackgroundResearch on neighborhood effects increasingly includes the influences of the built environment on health and social well-being.ObjectivesIn this population-based study in a low-socioeconomic-status (SES), Hispanic neighborhood, we examined whether architectural features of the built environment theorized to promote direct observations and interactions (e.g., porches, stoops) predicted Hispanic elders’ social support and psychological and physical functioning.MethodsWe coded built-environment features for all 3,857 lots in the 403-block area of an urban Miami, Florida, community. We then conducted three annual assessments of social support, psychological distress, and physical functioning in a population-based sample of 273 low-SES Hispanic elders (70–100 years of age). We used structural equation modeling analytic techniques to examine hypothesized relationships between the built environment and elders’ social support, psychological distress, and physical functioning over a 3-year period.ResultsAfter controlling for age, sex, and income, architectural features of the built environment theorized to facilitate visual and social contact had a significant direct relationship with elders’ physical functioning as measured 3 years later, and an indirect relationship through social support and psychological distress. Further binomial regression analyses suggested that elders living on blocks marked by low levels of positive front entrance features were 2.7 times as likely to have subsequent poor levels of physical functioning, compared with elders living on blocks with a greater number of positive front entrance features [b = 0.99; χ2 (1 df) = 3.71; p = 0.05; 95% confidence interval, 1.0–7.3].ConclusionsArchitectural features that facilitate visual and social contacts may be a protective factor for elders’ physical functioning.

Background Nature exposures may be associated with reduced risk of heart disease. The present study examines the relationship between objective measures of neighborhood greenness (vegetative presence) and 4 heart disease diagnoses (acute myocardial infarction, ischemic heart disease, heart failure, and atrial fibrillation) in a population‐based sample of Medicare beneficiaries. Methods and Results The sample included 249 405 Medicare beneficiaries aged 65 years and older whose location ( ZIP +4) in Miami‐Dade County, Florida, did not change from 2010 to 2011. Analyses examined relationships between greenness, measured by mean block‐level normalized difference vegetation index from satellite imagery, and 4 heart disease diagnoses. Hierarchical regression analyses, in a multilevel framework, assessed the relationship of greenness to each heart disease diagnosis, adjusting successively for individual sociodemographics, neighborhood income, and biological risk factors (diabetes mellitus, hypertension, and hyperlipidemia). Higher greenness was associated with reduced heart disease risk, adjusting for individual sociodemographics and neighborhood income. Compared with the lowest tertile of greenness, the highest tertile of greenness was associated with reduced odds of acute myocardial infarction by 25% (odds ratio, 0.75; 95% CI , 0.63–0.90), ischemic heart disease by 20% (odds ratio, 0.80; 95% CI , 0.77–0.83), heart failure by 16% (odds ratio, 0.84; 95% CI , 0.80–0.88), and atrial fibrillation by 6% (odds ratio, 0.94; 95% CI , 0.87–1.00). Associations were attenuated after adjusting for biological risk factors, suggesting that cardiometabolic risk factors may partly mediate the greenness to heart disease relationships. Conclusions Neighborhood greenness may be associated with reduced heart disease risk. Strategies to increase area greenness may be a future means of reducing heart disease at the population level.